Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer.
OBJECTIVE
To investigate preoperative serum CA-125 levels as a predictive factor for evaluation of lymph node metastasis in epithelial ovarian cancer.


METHODS
Retrospective study.


METHODS
Medical records at Seoul National University Hospital.


METHODS
Ninety-nine patients with epithelial ovarian cancer between January 2004 and March 2007.


METHODS
The significance of the preoperative serum CA-125 level for the prediction of lymph node metastasis was determined using the receiver operating characteristic (ROC) curve, McNemar's test and logistic regression analysis. Clinical prognostic factors affecting survival were evaluated using the Kaplan-Meier analysis with the log-rank test and Cox's proportional hazard analysis.


RESULTS
The ROC curve showed the best cut-off value (535 U/mL) of the preoperative serum CA-125 level with regard to sensitivity (70.0%) and specificity (83.1%). Imaging studies combined with the preoperative serum CA-125 level showed the highest sensitivity (90.0%), whereas imaging studies alone showed the highest specificity (89.8%) for the prediction of lymph node metastasis. FIGO stage III-IV, the preoperative serum CA-125 level (> or =535 U/mL) and lymph node involvement on imaging studies were significant factors for the prediction of lymph node metastasis (p<0.05). Suboptimal debulking surgery and lymph node metastasis were poor prognostic factors for progression-free survival and overall survival, respectively (p<0.05).


CONCLUSIONS
The preoperative serum CA-125 level (> or =535 U/mL) may be important for the prediction of lymph node metastasis in patients with epithelial ovarian cancer. Furthermore, it can be helpful in selecting patients who should undergo systemic lymphadenectomy for the detection of hidden lymph node metastasis.
Kim
Hee Seung
HS
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Park
Noh Hyun
NH
Chung
Hyun Hoon
HH
Kim
Jae Weon
JW
Song
Yong Sang
YS
Kang
Soon Beom
SB
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen